Onychomycosis is very common; prevalence rates are as high as 23% in Europe, 20% in East Asia and 14% in North America, and are expected to increase further. It becomes more common with increased age and in some patients with conditions such as diabetes and poor peripheral circulation. The fungus that causes onychomycosis (dermatophytes) is usually the same that that causing athlete’s foot. The nails in patients with onychomycosis become thickened, discoloured, disfigured and often split. This can cause physical as well as psychological distress.
Drug treatments are available for onychomycosis, with oral (taken by mouth) antifungal medicines generally being more effective than current topical ones (applied directly onto the nail). Terbinafine is the oral medication that is generally recommended for initial use in more severe cases when dermatophyte fungi are responsible; however, terbinafine tablets may have potentially serious side effects and can interact with other medicines, so are not suitable for all patients. Although topical treatments have fewer safety concerns, they tend to be less effective as it is difficult for an active substance applied topically to sufficiently penetrate through the nail barrier to the site of infection in the nail bed. Topical treatments also have longer treatment times (typically at least a year) and high levels of relapse as patients struggle to continue treatment for the necessary time.
Blueberry is developing a new topical antifungal spray formulation of terbinafine (BB2603‑om) for the treatment of onychomycosis using our nanodelivery platform technology. Our aim is to apply the spray directly to the nail, and through enhanced delivery of the active substance through the nail, to match the cure rates of the more effective oral formulations in a topical medicine, without the associated safety concerns.
More information for patients with onychomycosis can be found on the British Association of Dermatologists A-Z of treatments and conditions.
Information on Blueberry clinical trials in onychomycosis can be found on our clinical trials page.